Trial of interpersonal counselling after major physical trauma

Aust N Z J Psychiatry. 2007 Nov;41(11):926-33. doi: 10.1080/00048670701634945.

Abstract

Objective: The purpose of the present study was to determine if interpersonal counselling (IPC) was effective in reducing psychological morbidity after major physical trauma.

Methods: One hundred and seventeen subjects were recruited from two major trauma centres and randomized to treatment as usual or IPC in the first 3 months following trauma. Measures of depressive, anxiety and post-traumatic symptoms were taken at baseline, 3 months and 6 months. The Structured Clinical Interview for DSM IV diagnoses was conducted at baseline and at 6 months to assess for psychiatric disorder.

Results: Fifty-eight patients completed the study. Only half the patients randomized to IPC completed the therapy. At 6 months the level of depressive, anxiety and post-traumatic symptoms and the prevalence of psychiatric disorder did not differ significantly between the intervention and treatment-as-usual groups. Subjects with a past history of major depression who received IPC had significantly higher levels of depressive symptoms at 6 months.

Conclusion: IPC was not effective as a universal intervention to reduce psychiatric morbidity after major physical trauma and may increase morbidity in vulnerable individuals. Patient dropout is likely to be a major problem in universal multi-session preventative interventions.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Australia / epidemiology
  • Chronic Disease
  • Comorbidity
  • Counseling / methods*
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / prevention & control*
  • Depressive Disorder, Major / psychology
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Interpersonal Relations*
  • Male
  • Prevalence
  • Psychotherapy / methods*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / prevention & control*
  • Stress Disorders, Post-Traumatic / therapy
  • Stress Disorders, Traumatic / epidemiology
  • Stress Disorders, Traumatic / prevention & control
  • Stress Disorders, Traumatic / therapy*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology
  • Stress, Psychological / prevention & control
  • Trauma Centers / statistics & numerical data
  • Trauma Severity Indices
  • Treatment Outcome
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / psychology*